Further to my last blog post, check out:
The article compares the approaches taken by the US and Canadian governments with regard to driving use and adoption of healthcare IT, noting that “For Canadian observers, the US approach is highly instructive — although in many respects, discomfiting.” Points of differentiation noted by the article include:
- In the US, “Government leadership is showing results: crucial government-operated elements of the largely privately operated US health care system — such as the $47-billion Veterans Health Administration, which insures 23 million veterans and employs more than 239 000 staff at over 1400 sites — have almost completely implemented electronic health records, which are being made available to patients over the internet.”
- With regard to electronic record systems in physician offices, “federal leadership on this issue is providing instrumental, says Leary, who notes that the federal Office of Personnel Management, which manages health plans for millions of federal employees and retirees, is now legally required to ensure its health beneficiaries get access to EHRs.”
- “While the US incentives are nationwide and accompanied by tough measures to ensure that physicians actually use the EHRs paid for with government subsidies, Ottawa has left physician implementation to the provinces and has not tracked implementation.”
- “With two studies in press comparing Canadian and US approaches to EHRs, Robin Tamblyn with the McGill University Clinical and Health Informatics Research Group says US officials could learn from Canadian mistakes.”
What are your thoughts with regard to the CMAJ observations? Are there things that we are doing right in Canada? Are there some course corrections needed?
Mike
eHealth Musings 
By and large the CMA observations are spot on.
I take minor issue with the use of the VHA an example of success. I’ve heard multiple versions of the VHA story, some saying their system is a disaster and some who say it is a success. The truth is likely in the middle.
As for the rest of the story/observations, the CMA is very much on the money. The question that I can’t seem to square is can the issues realistically be fixed? To me the issue revolves around the federated model of healthcare delivery…the feds fund most of it and the province, by and large, deliver healthcare services in Canada. Never the two shall meet. Infoway, by its very nature has a limited funding/implementation role and cannot force provinces to do anything. They have the big stick known as “funding” but this only goes so far when you are talking about the political turf battles that surround healthcare.
Where is Health Canada in terms of setting and more importantly ENFORCING national standards. This to me is the difference. The US has a national body/org that has a carrot AND a stick to do pan-American eHealth standards and policy and we don’t. Is it any wonder that most of the Canadian owned eHealth vendors are looking south for opportunities.
Mark
Mark